Monday, June 28, 2010

So despite it being week 2 of the summer quarter, and despite the fact that I have not received feedback or full grades for assignments/papers from last quarters class, I got an A in that class!!! It's on the official transcript and I guess that's the one that really counts huh!?

So 7 quarters down, 5 more to go!! Let me just say I definitely did not go into grad school with the mindset of graduating with a 4.0, but now that I'm on a roll, I can't be stopped!! I'm working hard to keep that "perfect score" until I graduate (August 2011...and counting!!)

But we're down to crunch time...clinicals start this summer with health fairs which I'm actually excited about. Not so excited for the two 45 minute DVDs I have to make of myself giving full head to toe assessments and taking full patient histories (Jamie, get ready to put a gown on during vacation b/c the second DVD is due the next week!!), but I'm excited to actually start doing (some of) the work of an APN!!

I'm sure that with the health fares, back to school physicals, and other interesting clinical experiences this summer, I'll have more fun stories to share!! Stay tuned for many upcoming adventures of this PICU nurse.... : )

Sunday, June 27, 2010

This weekend Jon and I, along with 14 other friends, went down south for a camping trip! We definitely had a blast...great weather (jon would argue ridiculously hot, but that's my style!), amazing and private camp site, and great food!

But what I was laughing at (and sometimes kicking myself!) was how prepared (or should I say, NOT prepared!?) this PICU nurse was for camping!! Generally when I go places I am more prepared than the average person for a small disaster to happen around me. In my purse is a CPR mouth cover, some band-aids, some alcohol prep pads, and a few other odds and ends that could lend a hand in some first aid maneuvers.

So on the drive down I start getting a pretty bad headache...I reach in my medicine bag (that Jon and I take on ALL trips!) and what do you know, NO ibuprofin (or any of its equivalents!). Now typically this medicine bag is like a small pharmacy. Give me a medical complaint and I'll have a med on hand. But, nope, not this time!! Bummer!!

Over the course of the weekend I was asked numerous times for various "medical" things...NONE of which I actually brought along!! Most people just laughed and said, "Hey we counted on the nurse to bring that!"

What I should have packed in my camping bag: -ibuprofin -benedryl (yes, someone had an allergic reaction to watermelon!) -band-aids (several scrapes and scratches) -ginger (one guy puking, one guy having it come out other way!) *To give myself some credit, I did have a few pepto pills

Now on any other trip, my bag would have contained these items and SO many more that would never have been needed. Oh well, I guess this nurse was taking a vacation from nursing all together this weekend!!! Let me just say it was so much fun....and so worth it!! Everyone made it through the weekend happy and healthy! But, as the saying goes, all good things must come to an end. With that, this nurse goes back on duty tomorrow.

Wednesday, June 23, 2010

Work on Monday and Tuesday was slightly disappointing. Partly because my guy's trach and g-tube was put off....for the 3rd time!! I was really excited that I'd be the one to take him to surgery Monday, and be there for him and his family for his first two days....but that didn't work out. If all goes as planned, he'll get it today (on my day off)....and I won't be at work until next Tuesday. YEAH for days off....boo for not being able to be there for the big OR day.

But the main reason it was disappointing was because a 9 year old got under my skin!! I took care of the same liver transplant boy as crazy Saturday shift mentioned before....although on Monday and Tuesday he was not so paralyzed/sedated/intubated as he once was. Translation: he was a 9 year old with ADD who was getting incredibly bored with being in the hospital!

So, despite my constant attempts at trying to keep his pulse-ox on (a simple band-aid like contraption that wraps around your finger or toe) he continued to pull it off. Several times through the day he tried to kick me as I tried putting it on his toe. And several times I was swatted away when trying to empty his drains. My patience was running really thin with this kid!!

And then he decides to start the name calling. While putting his pulse ox back on (for the 100th time!) I was called "Fart Face"....when putting his EKG lead on I was called "Potato head"....while re-snapping the buttons on his gown so he wasn't totally naked I was called "stinky face"....while (almost) yelling at him to stop pulling on his drains (which only by the Grace of Liver Transplant God remained in place because this kid ripped off the occlusive dressing and was PULLING on the tubes crazy style! I thought he was gonna pull his liver right out with the tubes!!) I was called "mean head." I had to step away because this 9 year old was starting to get on my last nerve!!

But what topped it off was when, once again, I was putting the pulse ox back on and he called me "Fart Face," his mom laughed and said "Funny, in his way, that's a compliment!"

OK- I don't care whose way you are referring to....name calling is NEVER a compliment!! How should I interpret FartFace as a compliment?? My face is as nice as a fart?? My farts are as nice as my face??

Instead, I looked at him and said "Name calling is never a joke. It can hurt other people's feelings." There were so many other things I would have rather said, but I didn't. I kept it to the level of an ADD 9 year old....and appropriate enough so I would keep my job!

So I left that evening slightly disappointed. Walking out, I told my carpool buddy "work today was draining....work was hard...and parts of it sucked....but in my way, that's a compliment!"

Friday, June 18, 2010

Wow- time does surely go fast! I can't believe that it's been 3 weeks since my last post! Certainly work has been interesting and extremely busy. I mean ridiculous busy! Our census has been super high...if not completely full causing us to have to open up our overflow unit. Oh, and to add to it, we've also been short staffed. So that's a winning combination!!

School is done for the week. I finished up a super easy class....well, I'm assuming that it was super easy. Of the five things we did throughout the entire quarter, I have one grade. We were supposed to get grades by Monday. Ok, it's Friday and still, nothing! I'm just saying, if I get anything less than an A I'll be ticked!! Not just because it was an easy class, but on principle! How can you not give feedback an entire quarter and then give a student less than an A. If we could only give our professors a grade too....

Updates on work: still taking care of my teenage guy. Right before I went on vacation (oh yeah, forgot to mention we went away for our 5 year anniversary...CANNOT believe I've been a Mrs. for 5 years!!!) he wanted to keep me on my toes. Long story short, he basically decided to not breath well, causing his CO2 levels to sky rocket, causing him to be completely unarousable. So, he bought himself and breathing tube that day! As I left that night, I told him I was off work for 10 days but would be back and he better not be intubated (breathing tube still in) when I got back.

I held my end of the deal....I came back to work. He did not hold his! He was still intubated! BUT- apparently, he was just saving extubation (taking the breathing tube out) for me! So we extubated last Friday. Saturday morning I came back and he definitely was not looking so hot.

But this is where it gets interesting! Staffing is super bad....census is super high! I get to draw up intubation meds for my little guy b/c his breathing is not so great again. Oh, AND I also get to take back a liver transplant. At the same time! Yeah there's some fun for ya!

For those of you who know (ok, who am I kidding...there are no medical providers following my blog!) liver transplants come out bleeding, needing lots of blood, typically have blood pressure issues, needing dressing changes, intubated and needing sedation/pain medications, lots and lots of labs to be drawn...etc etc etc. = Liver transplant patients are EXTREMELY busy!!

Never ever is this assignment paired (one nurse, two patients). BUT for me it was!! And with a patient that needed intubated at that! Let me just tell you, if ever there were a day that I was "drowning" this was it! The only thing that could have made it worse was to have mean or rude parents. Sad that I'm so accustomed to this that it was kinda just an assumption. But, I totally lucked out and liver transplant mom and dad were the nicest people ever!

I made it out of there Saturday night at around 9 and got home a little after 10pm. LONG DAY!! As I was leaving the charge nurse said "Well, at least tomorrow will be better!" to which I responded "Um, yeah, it definitely will because I'm not here tomorrow!"

Sunday was a great day off....not relaxing but just so great not to have to be PICU nurse for the day.

Monday and Tuesday I was back at it. Because my little guy has "failed extubation" twice now recently, we decided that it would be best for him to get a trach (more permanent breathing tube in your neck) and a gastrostomy tube (tube in your stomach that you can be fed through). It's been sad for me to see how see how sad the little guy is because he knows he needs the trach, but he definitely does not want it. And, just when he was starting to talk to me, it's sad that he no longer has a voice....but that will come with time again, after the trach.

That being said, despite no voice...he still has his fiesty personality which keeps me laughing! Monday he was quite angry that he was intubated again and knew he needed the trach. We were playing Bingo and we were not winning....so not a good day for this guy! The nutritionist came in the room and he hand motioned her to "zip your lips" and then shoo'ed her out of the room with his arm! We had a brief talk about how even when we're mad we shouldn't be rude to other people, but then I just had to walk away and laugh! This delayed teen just told the nutritionist to Zip Your Lips! So funny!

He gets his trach and g-tube on Monday (I'm working which is good b/c I'll be able to send him to the OR and take him back). There will be tons and tons of family teaching involved with both of these new things, so I'm sure it will provide some interesting stories along the way (especially because all this teaching will have to be done with a Spanish interpreter for dad!).

So- it has been an exciting, busy past few weeks! School starts again on Monday....physical assessment class which I'm sure will be oh so interesting. I have to do history and physicals on video for assignments so that will be interesting! Keep a lookout, I might post a video so you can see me in action : )

Long enough blog post for now! That's why 3 weeks should not go by without posting, because so much craziness can happen in the PICU in that amount of time! I guess it's why I love my job so much! Always changing, always keeping you on your toes, occasionally maddening....but definitely rewarding!

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About Me

I am a new PICU Nurse Practitioner working in the same PICU where I had previously been a bedside nurse for 7 years. This blog is a way for me to document the many fun, memorable, crazy things that come out of taking care of PICU patients. And occasionally I like to throw in some personal documentation of other things that I love- cooking meals with my man, drinking a great glass of wine, decorating my home, thrift shopping, high heel wearing, and traveling. This is my adventure...thank you for stopping in to enjoy the ride!
DISCLAIMER: Any stories in this blog are written to protect patient confidentiality and not violate HIPPA. Names, ages etc. have been changed. If you think that I'm talking about you, I'm not...there are tons of other patients out there that have the exact diagnosis as you, and the same loving/crazy/wonderful/stressed out/amazing/wacko parents to back them up! : )